This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Thursday, August 25, 2016

The Macro View – Health And Political News Relevant To E-Health And Health In General.

August 25 Edition.

The big issue for this week will be just how the politics will play out and what impact it will have as Parliament comes back with the new government in the next week (Starts Monday 29 August, 2016).

Otherwise we have the Northern Hemisphere on Summer holidays – leading to very stable markets mostly.

In Australia we have the ongoing nonsense and political contention that is blocking progress.

There three paragraphs from the outgoing Reserve Bank Governor says it all!

“He observed that "when specific ideas are proposed that will actually make a difference [to the budget deficit] the conversation quickly shifts to rather narrow notions of "fairness", people look to their own positions, the interest groups all come out and the specific proposals often run into the sand.

"If we think this rather other-worldly discussion will not have to give way to a more hard-nosed conversation, we are kidding ourselves.

"That will occur should there be a moment of crisis, but it would be better if it occurred before then," he said.”

With the Health Minister at RIO we have policy quietness in the Health Sector for the moment.

General Budget Issues.

Ross Gittins

The last speech of the retiring Reserve Bank governor, Glenn the Baptist, was a touch biblical. Whatever your point of view, you could find a verse here or there that seemed to back you up.

If, for instance, you accept the conventional view that the budget deficit is way too high, that the government should be more daring in seeking to cut the deficit, and its opponents should be less opportunist and more responsible in agreeing to spending cuts, Glenn Stevens offered a verse for you to quote.

He observed that "when specific ideas are proposed that will actually make a difference [to the budget deficit] the conversation quickly shifts to rather narrow notions of "fairness", people look to their own positions, the interest groups all come out and the specific proposals often run into the sand.

"If we think this rather other-worldly discussion will not have to give way to a more hard-nosed conversation, we are kidding ourselves.

"That will occur should there be a moment of crisis, but it would be better if it occurred before then," he said.

A change to the way the GST is distributed among the states won't be made anytime soon, Treasurer Scott Morrison says.

Mr Morrison was defending what Prime Minister Malcolm Turnbull told the WA Liberal Party state conference about his plan to put a floor under the revenue carve-up - a move that would benefit the West.

'No one envisaged that the current way things are done would lead to a situation where Western Australia would just get 30 per cent of the GST that their people paid,' he told Macquarie radio on Monday.

Ross Gittins

I have disturbing news. The big business people of Australia are feeling quite upset about the recent federal election, or so I am informed by The Australian Financial Review.

Quite frankly – and this is a shocking thing to say – the mood of the campaign was "anti-business". As young people say, big business was disrespected.

Those rotters in the Labor Party were shameless in their behaviour, seeking to win votes by portraying their Liberal opponents as apologists for big business.

Why did the Libs have cutting the rate of company tax as pretty much the only item in their plan for Jobs and Growth? Purely, so the voters were asked to believe, to please the Libs' cronies at "the big end of town".

Big business has had it tough for too long. Just ask them

Ross Gittins

I have disturbing news. The big business people of Australia are feeling quite upset about the recent federal election, or so I am informed by The Australian Financial Review.

Quite frankly – and this is a shocking thing to say – the mood of the campaign was "anti-business". As young people say, big business was disrespected.

Those rotters in the Labor Party were shameless in their behaviour, seeking to win votes by portraying their Liberal opponents as apologists for big business.

Why did the Libs have cutting the rate of company tax as pretty much the only item in their plan for Jobs and Growth? Purely, so the voters were asked to believe, to please the Libs' cronies at "the big end of town".

Peter Martin

adj. Rashly or wastefully extravagant: a prodigal nephew who squandered his inheritance.

Western Australia wants the rest of us to bail it out.

Without warning, the GST lifeline it needs to fund its operations has collapsed, or so it says.

Our Treasurer, Scott Morrison, seems to believe it. Here is he on Monday telling radio host Ray Hadley no one saw it coming: "The simple point that the Prime Minister is making is this, no one envisaged that the current way things are done would lead to a situation where Western Australia would just get 30 per cent of the GST that their people paid."

David Crowe

Bill Shorten is holding out against $6 billion in budget cuts he “banked” in Labor’s election platform only weeks ago, shattering talk of a consensus on fiscal repair as he blasts Malcolm Turnbull for trying to legislate the savings.

Labor prepared the ground to reject or amend the most controversial measures, including cuts to renewable energy funding and welfare programs, despite renewe­d calls for both major ­parties to find common ground to fix the nation’s $37bn deficit.

Scott Morrison accused the Opposition Leader of “budget sabotage” by questioning the plan for an omnibus bill to legislate government savings that were made clear during the election campaign and adopted in Labor’s alternative budget.

The federal government has used the decision of a second ratings agency to confirm Australia's triple-A ratings to increase pressure on Labor to pass its budget savings.

Treasurer Scott Morrison noted the Moody's decision on Wednesday cited risks to its fiscal consolidation plans, which are aimed at saving $6.5 billion.

"Support in the parliament to implement the Turnbull government's economic plan for jobs and growth, to avoid higher debt and reduce the deficit is necessary to support maintaining our triple-A rating," he said.

Judith Sloan

Once upon a time, retail was the biggest employment sector in Australia. For some time, health and social assistance have provided the most number of jobs and have experienced extremely rapid growth for more than a decade.

While not all jobs in health and social assistance are in the public sector, many private sector jobs in those sectors are also dependent on taxpayer funding — think Medicare and the National Disability Insurance Scheme.

We also know that federal government spending has gone from 23.1 per cent of GDP in 2007-08 to an estimated 25.8 per cent in 2016-17. Annual federal spending is fast approaching half a trillion dollars.

The new head of the Australian Medical Association has warned conservative politicians that altering Medicare will come at a political cost.

Stephanie Peatling

The new head of the Australian Medical Association has warned conservative politicians to stop "fiddling around" with Medicare, saying it is a "totem" for voters who do not want it changed.

Dr Michael Gannon told the National Press Club in Canberra that Labor's so-called Mediscare campaign in the federal election campaign was successful because there was a "very strong undercurrent of fear and uncertainty" among voters as a result of the Coalition's 2014 budget.

"The Coalition government went to the election oblivious to, or unprepared for, the community's concerns about health services," Dr Gannon said on Wednesday.

"Right or wrong, co-payments became code for attacks on poor and disadvantaged people in the community. They were seen as attacks on sick people. They were seen as attacks on working families with young kids. In short, the co-payment strategy was a political disaster."

·Lesley Russell

Last month it was announced that the 2016 Boyer lecture series would be delivered by Sir Michael Marmot, a leading researcher on health inequality. He will explore how health is not simply a matter of genetics and access to healthcare but is intrinsically linked to economic and social factors. This lecture series comes at a time of growing recognition of the increasing inequalities in income and wealth and the subsequent impacts on health.

The social determinants of health include the obvious physical things such as clean water and air, healthy workplaces, adequate housing, transportation services and safe communities. Education and employment provide income and make housing, food and healthcare affordable. Equally important are less tangible factors such as social support networks, culture and beliefs, stress and exposure to violence, discrimination and racism.

The strong associations between these factors and health outcomes mean that providing for the health and wellbeing of the population requires more than hospitals, doctors and prescription pads and tackling the wicked issues such as obesity, ageing, mental health reforms and Closing the Gap on Indigenous disadvantage requires government involvement beyond the Department of Health. There can be no question that government involvement is essential for two reasons: many of the determining factors for health lie beyond the ability of individuals and communities to influence and population health contributes to national productivity and prosperity.

Sean Parnell

Australian Medical Association president Michael Gannon has called on Malcolm Turnbull and Health Minister Sussan Ley to “stare down” their cabinet colleagues and restore funding to the sector.

While acknowledging the underlying budgetary pressures, Dr Gannon yesterday said there was no health spending crisis and the recent federal election demonstrated that consumers valued any investment in public healthcare.

“In close consultation with the medical profession, the government can make wise and sustainable investments in health,” Dr Gannon told the National Press Club in Canberra.

“This will create tension within the government. But the Prime Minister and the Health Minister must stare down Treasury and Fin­ance to maintain health as a priority issue — and a political survival issue — for the Coalition.”

He says said the ongoing review, which kicked off last year, is hurting practitioners and that proposed changes will hit independent GPs the hardest.

"If the MBS review continues that is squeezing healthcare practitioners ... it's squeezing us. Now, we have the added advantage of scale and efficiency which helps us absorb some of that - smaller practices do not," Mr Gregg said on Wednesday as his business posted a 41.3% drop in full-year profit to $74.9 million.

Health Insurance Issues.

Health fund members are paying ever higher premiums but getting back less in benefits while fund profits have ballooned, according to the latest official figures.

Health fund profits have jumped by a lucrative 8.9 per cent yet the latest statistics show that members are on average getting less back from each dollar in premiums they pay.

While premium revenues rose by 6.4 per cent in the year to June, the payouts members got back in benefits rose by just 5.3 per cent, according to figures released by the Australian Prudential Regulation Authority.

“These results underline the need for a searching review of the state of health insurance,” the CEO of the Consumers Health Forum, Leanne Wells said.

Esther Han

Private health fund members paid a record $22 billion in premiums in the past financial year, but received less back on each dollar, latest industry figures show.

New data released by the Australian Prudential Regulation Authority shows private health funds managed to boost premium revenues by 6.4 per cent and profit before tax by 8.9 per cent in the year to June.

But payouts to their members rose by just 5.3 per cent.

The industry says returning a profit – or a surplus in the case of not-for-profits – is a positive sign that the business is being "run responsibly and not bad for consumers".

Sean Parnell

Australia’s second-largest health insurer has questioned whether doctors with financial interests in technology and facilities have a conflict of interest they should be forced to declare to their patients.

In a submission to the Prod­uctivity Commission, Bupa has repeated its previous call for ­reforms to the prostheses list, ­expected to be taken up by the Turnbull government.

But Bupa has also asked the commission to review commercial arrangements in private health and whether doctors should be required to provide ­patients with details of any financial interests they hold in medical facilities or equipment.

Bupa health insurance managing director Dwayne Crombie has previously questioned the use of robotic equipment for prostate cancer surgery, with data showing more than a quarter of the ­operations funded by Bupa left patients with out-of-pocket costs of between $5001 and $10,000.

Elizabeth Redman

Private health insurer Medibank has reported a jump in profit after increasing its premiums and reducing cover, following a controversial set of negotiations with hospitals as it transitions to life as a public company.

Net profit attributable to shareholders surged 46.4 per cent to $417.6 million in the year to June 30, compared to $285.3m in the prior year.

The insurer (MPL) said premium revenue lifted 4 per cent in the year, after the federal government approved average premium rate rises of 6.59 per cent from April 2015 and 5.64 per cent from April 2016.

With Medibank Private releasing its annual results on Friday and Sonic Healthcare and Primary Health Care reporting yearly profits on Wednesday, political attention is turning to whether taxpayers are getting value-for-money from the government incentives paid to the private health industry.

Mr Gannon said although Australia's health funding was in need of genuine reform, taxpayer incentives to private pathology providers still delivered "bang for your buck".

Pharmacy Issues.

Rania Spooner

An expensive breakthrough drug that prevents people from getting HIV won't be funded by taxpayers in Australia this year, the nation's drug funding panel has ruled.

Truvada, a once-daily pill shown to be highly effective at preventing HIV in people at risk of getting the virus, costs about $1200 a month to buy in Australia. It can also be bought on the internet and imported into Australia for less than $100.

HIV advocates and groups say the drug is so popular among men having sex with men that it has the potential to halve the number of HIV transmissions in Australia within a year if it was made more affordable.

The antiretroviral drug, which is being used as a strategy known as "pre-exposure prophylaxis (PrEP)", was approved for use in Australia in May.

David Crowe

Scott Morrison has hit another barrier in his bid to legislate a $6 billion tax hike on superannuation, as Liberal MPs insist on bigger changes to the divisive budget measure before they sign off on the plan when parliament ­resumes within weeks.

Liberals MPs told The Weekend Australian their constituents wanted greater concessions than the Treasurer’s mooted proposal to lift the $500,000 lifetime cap on post-tax super contributions to $750,000 in order to soften the impact on workers and retirees.

With more talks scheduled for the week ahead, Mr Morrison is being asked to lift the cap to $1 million in the hope of ending the ­dissent over the policy, so it can be fast-tracked through the Coalition partyroom and put into force.